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michaeldcoe · 7 years ago

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'Doctors learn nothing about nutrition'

Image copyright Getty Images Image caption The health effects of nutrition and diet are not part of traditional training for medical students

Medical students say they currently learn almost nothing about the way diet and lifestyle affect health - and they should be taught more.

They say what they are taught is not practical or relevant to most of the medical problems they see in GP surgeries, clinics and hospitals. A leading GP estimated that up to 80% of his patients had conditions linked to lifestyle and diet. These included obesity, type 2 diabetes and depression. Why does this lack of training matter?

This year the NHS will spend more than £11bn on diabetes alone - social care costs, time off work etc, will almost double that bill. Type 2 diabetes - the most common kind - is linked to obesity. And right now Britain is the fat man of Europe.

Training too traditional

But doctors are not being trained to deal with what medics call non-communicable diseases - and it's those kind of illnesses that are threatening to bankrupt our health system, so a new kind of training is crucial. Speaking to BBC Radio 4's The Food Programme, Dr Rangan Chatterjee, GP and presenter of BBC One's Doctor in the House, told me: "The health landscape of the UK has dramatically changed over the last 30 or 40 years and I think the bulk of what I see as a GP now - almost 80% - is in some way driven by our collective lifestyles." Dr Michael Mosley, presenter of BBC One's Trust Me I'm A Doctor, said, "Unfortunately it's not part of the traditional training. At medical school I learnt almost nothing about nutrition. And I have a son at medical school and it's again not part of his key curriculum. "So I don't get the sense that there are lots of doctors out there who feel empowered to tell patients much about nutrition."

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A hotbed of the new revolution is Bristol University where, in 2017, third year medical students Ally Jaffee and Iain Broadley founded Nutritank. It's an online organisation created for and by medical students to share nutrition science research and organises events and lectures on campus. This summer, it will welcome GP, author and podcast host Dr Rupy Aujla to Bristol to lead the first UK course in culinary medicine for medical students. From one society in Bristol, Nutritank has now spread to 15 other student-led groups at universities across the country.

'It's time'

Ally Jaffee said: "There's just about a society at medical school in everything from sexual health to orthopaedics to dermatology. But there just wasn't a nutrition and lifestyle or a preventative medicine society. "We're taught about 10 to 24 hours over five to six years in medical school on nutrition." This month, the British Medical Journal announced it will launch a journal on the science and politics of nutrition in June 2018. Dr Fiona Godlee, editor-in-chief of the BMJ, told me, "It's time we recognised that food and nutrition are core to health. There is a growing body of research out there that needs to be published - and we want to contribute to that effort."

Image copyright SCIENCE PHOTO LIBRARY Image caption What people eat has a bearing on their general health, doctors say She said the same levels of quality and scrutiny should be applied to food science that are applied to other areas of health research. The BMJ's announcement follows an opinion piece it published in October 2017 written by two University of Cambridge graduate medical students, Kate Womersley and Katherine Ripullone. Kate said: "I was in an obesity clinic as part of my medical shadowing. "A patient came in and said very frankly to the doctor, the consultant in charge, 'Why am I so fat?'. "The patient was asking a very straightforward question and I think was expecting a straightforward answer. But often that's a question where doctors seem to clam up a bit. "We were interested to write this piece for the BMJ, because we didn't feel prepared to be receiving that question."

Read more: http://www.bbc.com/news/uk

http://coehealthandfitnessreport.com/?p=1505

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michaeldcoe · 7 years ago

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10 charts that show why sleep is so important

Image copyright Getty Images

1. We're told to get our eight hours

We often hear that we should all be getting eight hours' sleep a night. Organisations from the NHS to the US National Sleep Foundation recommend it. But where does this advice come from?

Studies carried out around the world, looking at how often diseases occur in different groups of people across a population, have come to the same conclusion: both short sleepers and long sleepers are more likely to have a range of diseases, and to live shorter lives.

But it's hard to tell whether it is short sleep that is causing disease or whether it is a symptom of a less healthy lifestyle.

Short sleepers are generally defined as those who regularly get less than six hours' sleep and long sleepers generally more than nine or 10 hours' a night.

Pre-puberty, children are recommended to get as much as 11 hours' sleep a night, however, and up to 18 hours a day for newborn babies. Teenagers should sleep for up to 10 hours a night.

Shane O'Mara, professor of experimental brain research at Trinity College Dublin, says that, while it's difficult to tell whether poor sleep is a cause or a symptom of poor health, these relationships feed off each other.

For example, people who are less fit exercise less, which leads people to sleep badly, become exhausted and less likely to exercise, and so on.

We do know that chronic sleep deprivation - that is, under-sleeping by an hour or two a night over a period of time - has been linked time and again by scientists to poor health outcomes: you don't have to go for days without sleep to suffer these negative effects.

How much can an extra hour's sleep change you?

2. What happens in your body when you don't sleep enough?

Poor sleep has been linked to a whole range of disorders.

A review of 153 studies with a total of more than five million participants found short sleep was significantly associated with diabetes, high blood pressure, cardiovascular disease, coronary heart disease and obesity.

Studies have shown that depriving people of enough sleep for only a few nights in a row can be enough to put healthy adults into a pre-diabetic state. These moderate levels of sleep deprivation damaged their bodies' ability to control blood glucose levels.

Vaccines are less effective when we are sleep deprived, and sleep deprivation suppresses our immune system making us more prone to infection.

One study found participants who had fewer than seven hours of sleep were almost three times more likely to develop a cold than those who slept for seven hours or more.

People who don't sleep enough also appear to produce too much of the hormone ghrelin, associated with feeling hungry, and not enough of the hormone leptin, associated with feeling full, which may contribute to their risk of obesity.

There are also links to brain function and even in the long term to dementia.

Prof O'Mara explains that toxic debris builds up in your brain during the course of the day and waste is drained from the body during sleep. If you don't sleep enough, you end up in a mildly concussed state, he says.

The impact of sleeping too much is less understood, but we do know it is linked to poorer health including a higher risk of cognitive decline in older adults.

'Box set Britain': Millions skip sleep to binge-watch TV

3. We need different types of sleep to repair ourselves

After we fall asleep we go through cycles of "sleep stages", each cycle lasting between 60 and 100 minutes. Each stage plays a different role in the many processes that happen in our body during sleep.

The first stage in each cycle is a drowsy, relaxed state between being awake and sleeping - breathing slows, muscles relax, the heart rate drops.

The second stage is a slightly deeper sleep - you may feel awake and this means that, on many nights, you may be asleep and not know it.

Stage three is deep sleep. It is very hard to wake up during this period because it is when there is the lowest amount of activity in your body.

Stages two and three together are known as slow wave sleep which is usually dreamless.

After deep sleep we go back to stage two for a few minutes, and then enter dream sleep, also called REM (rapid eye movement). As the name suggests, this is when dreaming happens.

In a full sleep cycle a person goes through all the stages of sleep from one to three, then back down to two briefly, before entering REM sleep.

Later cycles have longer periods of REM, so cutting sleep short has a disproportionately large effect on REM.

4. Shift workers who have disturbed sleep get sick more often

Shift work has been associated with a host of health problems. Researchers have found shift workers who get too little sleep at the wrong time of day may be increasing their risk of diabetes and obesity.

Shift workers are significantly more likely to report "fair or bad" general health according to a 2013 NHS study, which also found people in this group were a lot more likely to have a "limiting longstanding illness" than those who don't work shifts.

People who work shifts are significantly more likely to take time off sick, according to figures from the Office for National Statistics.

There is a far bigger gap for non-manual workers than manual workers - lack of sleep seems to have a bigger impact on those doing more sedentary jobs.

5. And many of us are feeling more sleep deprived than ever

To judge from media reports, you'd think we were in the grip of a sleeplessness epidemic. But are we really all more sleep deprived than before?

A big piece of research looking at data from 15 countries found a very mixed picture. Six showed decreased sleep duration, seven increased sleep duration and two countries had mixed results.

Lots of a evidence suggests the amount we sleep hasn't changed that much in recent generations.

But if you ask people how sleep deprived they think they are, a different picture emerges.

So why do so many people report feeling tired?

It may be that this problem is concentrated in certain groups, making the trend harder to pick up on a population-wide level.

Sleep problems vary considerably by age and gender, according to one study of 2,000 British adults. It found women at almost every age have more difficulty getting enough sleep than men.

The sexes are more or less level at adolescence but women begin to feel significantly more sleep deprived than men during the years where they may have young children, while work may become more demanding. The gap then shrinks again later in life.

Caffeine and alcohol both affect sleep duration and quality.

And later nights and more social activities mean some of us are getting less rest, despite having the same number of hours of sleep, according to Prof Derk-Jan Dijk, of the University of Surrey's sleep research centre.

Some people may also sleep too little during the week and catch up at the weekend, bringing the average up but leaving those people feeling sleep deprived.

Adolescents are particularly at risk of becoming sleep deprived, according to Prof Dijk.

6. But we didn't necessarily always sleep this way

Aside from a few outliers - Margaret Thatcher could apparently get by on only four hours a night - people tend to go to bed in the late evening for around seven or eight hours.

But this wasn't necessarily always the norm according to Roger Ekirch, a history professor at Virginia Tech in the USA. He published a paper in 2001 drawn from 16 years of research.

His subsequent book, At Day's Close, contained a wealth of historical evidence suggesting that hundreds of years ago, humans in many parts of the world slept in two distinct chunks.

Dr Ekirch uncovered more than 2,000 pieces of evidence in diaries, court records and literature which suggest people used to have a first sleep beginning shortly after dusk, followed by a waking period of a couple of hours, then a second sleep.

The myth of the eight-hour sleep

He thinks this means the body has a natural preference for segmented sleep.

Not all scientists agree. Other researchers have found hunter-gatherer communities in the modern world who sleep in one block despite not having electric lighting. This suggests sleeping in two blocks is not necessarily our default.

According to Dr Ekirch the shift from biphasal to monophasal sleep happened in the 19th Century because domestic lighting pushed bedtimes later with no corresponding change in rising time, improved lighting changed the human body clock, and the industrial revolution put a greater emphasis on productivity and efficiency.

7. Phones are keeping teenagers awake

Sleep experts say teenagers need up to 10 hours sleep a night, but almost half don't get this much according to the NHS.

Bedrooms are supposed to be a place of rest but are increasingly filled with distractions like laptops and mobile phones, making it harder for young people to nod off.

We have more different types of entertainment on offer than ever, making the temptation to stay awake greater. The blue light emitted by electronic devices makes us feel less sleepy. And the activity itself - be it talking to friends or watching TV - stimulates our brain when it should be winding down.

Digital Awareness UK and the Headmasters and Headmistresses Conference recommend a nightly "digital detox", putting mobile devices away for 90 minutes before lights out.

Last year the two organisations commissioned a poll which found a high proportion of young people check their phones after going to bed.

8. Testing for sleep disorders is on the up

More people are turning up at their doctors complaining of problems sleeping.

Analysing data collected by NHS England, the BBC found in June that the number of sleeping disorder tests had increased every year over the past decade.

There are a number of factors, but the biggest is probably the rise in obesity, according to Dr Guy Leschziner, a consultant neurologist at Guy's and St Thomas' Hospital's Sleep Disorders Centre.

The most common and fastest-growing complaint he sees is obstructive sleep apnoea - where the airway collapses and people stop breathing in their sleep - and this is strongly related to weight.

The media has also played a role because people are more likely to go to their GPs having read an article or searched for their symptoms online, he says.

The recommended treatment for insomnia is cognitive behavioural therapy, and doctors are increasingly aware that they shouldn't be prescribing sleeping pills. But many still do because it's difficult to access non-drug based treatments, particularly outside big cities.

Body Clock: What makes you tick?

9. Are other countries doing it differently?

One study looked at sleep habits in 20 industrialised countries.

It found variations of up to an hour in the time people went to bed and woke up, but overall sleep duration was fairly constant across countries. Generally, if a population on average went to bed later, they woke up later too, although not in every case.

Researchers have concluded that social influences - hours worked, timing of school, leisure habits - play a far bigger role than the natural cycle of light and dark.

In Norway, where the period of lightness each day varies through the year from zero to 24 hours, sleep duration throughout the year only varies on average by about half an hour.

Both in countries like the UK, where dusk and dawn times vary considerably across the seasons, and in countries closer to the Equator where dusk and dawn times vary minimally, sleep duration remains constant through the year.

But what about the impact of artificial light?

A study of three communities who had no access to electricity, in Tanzania, Namibia and Bolivia, found the average sleep duration was 7.7 hours - in step with industrialised countries.

So sleep duration seems remarkably consistent throughout the world - it's the time we all go to bed and wake up that varies slightly.

These pre-industrialised communities did not fall asleep as soon as it got dark, but around three hours after sunset and generally woke before sunrise.

Most studies in this area suggest that artificial light delays sleep time but does not necessarily decrease overall sleep duration.

10. Morning larks, night owls?

There have always been morning people and evening people. We even have genetic evidence that backs this up.

But the introduction of artificial light appears to have exacerbated this effect, particularly for people who prefer to stay up late.

If you are already inclined towards being a night owl, artificial light will make you stay up even later.

About 30% of us tend towards being morning people and 30% towards being evening people, with the other 40% of us somewhere in the middle - although marginally more people prefer early rising to late nights.

We do have some control over our body clocks, however. Those who are naturally late to bed and late to rise can try reducing their exposure to light in the evenings and making sure they get more light exposure in the daytime.

A team of researchers took a group of volunteers camping in Colorado, where they had no access to artificial light. Only 48 hours was enough to shift the campers' body clocks forward by almost two hours.

Levels of melatonin, the hormone that tells our body to prepare for sleep, began rising earlier in the volunteers - their bodies were preparing for sleep much closer to sunset.

Related Topics

Sleep

Read more: http://www.bbc.com/news/uk

http://coehealthandfitnessreport.com/?p=1496

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michaeldcoe · 7 years ago

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Inside UK lab that identified ex-spy nerve agent

Image caption Porton Down is building a facility for the analysis of explosives

The UK's military research base at Porton Down has been at the heart of the investigation into what happened to Russian former spy Sergei Skripal and his daughter Yulia. The BBC has been granted exclusive access to the Wiltshire lab.

The headquarters of the Defence Science and Technology Laboratory (DSTL) at Porton Down is a sprawling campus.

Stern warning signs and red flags make clear it is a sensitive facility as you approach. And beyond the security perimeter, there are buildings old and new, some with open-plan offices, others with labs.

An urgent call came in here in the early hours of Monday 5 March.

DSTL is used to being contacted in response to major incidents in the UK such as terrorist attacks. But this was different.

This time the incident was only a few miles down the road in Salisbury. A man and a woman had been found on a park bench the previous day and it had become clear they were not suffering from an ordinary illness.

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Russian spy: What we know so far

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A few hours after the call, one of the Specialist Response Teams, ready 24/7 for such calls, was deployed.

Military grade

The initial symptoms from the patients seemed consistent with a nerve agent. The team collected samples which were then analysed at the labs in Porton Down.

Media playback is unsupported on your device

Media captionPorton Down chief: Russia's poison accusation 'just not true'

We were shown one lab where one type of test can be undertaken on such samples, but officials will not go into details about the exact chemistry involved with the tests after Salisbury.

However, the tests did confirm that a military-grade nerve agent had been deployed on the streets of Britain. A combination of this scientific analysis and other information would in turn lead to the government's conclusion that it was highly likely Russia was behind the attack.

DSTL officials say that its role has been to use its scientific expertise to support the police investigation, including the need to keep material forensically secure so there is a proper evidential trail, as well as assist the medical teams involved in treatment and help with broader public health concerns.

It has been helping check the police and emergency workers who have been to various locations to make sure that they have not been contaminated. This has all led to a far higher profile for the site than it has been used to.

'No way' chemicals escaped

We were invited into the site but there were strict limits about what we were able to see. Armed police and dogs patrol the perimeter.

Not all the attention has been welcome. Russian officials have made pointed reference to the proximity of Porton Down to Salisbury with the suggestion the nerve agent might even have come from here.

Image caption Chief executive Gary Aitkenhead said Porton Down had the highest levels of controls of security

That is something the chief executive of DSTL is firm in denying. "We've got the highest levels of controls of security around the work that we do here," Gary Aitkenhead told me.

"We would not be allowed to operate if we had lack of control that could result in anything leaving the four walls of our facility here.

"There's no way that agent would have left. We have complete confidence that nothing could have come from here out into the wider world."

Asked if it was frustrating to hear such accusations, he said: "It is coincidence that it is down the road that this has happened. It is frustrating to hear that and it is just not true. "

Image caption Porton Down emphasises the work undertaken there is purely defensive

Officials are keen to emphasise that the work here is defensive only. In one building, the size and shape of a bungalow, we are shown a sealed metal chamber.

Inside a robot called "Porton Man" wears a military protection suit as live agents are pumped in. The aim is to see what defence the suit offers over time as the robot moves.

Huge effort needs to then go into cleaning the chamber and disposing of the agents. The work here is also much broader then just dealing with chemical and biological weapons but also covers ballistics, explosives and cyber security amongst other fields.

Officials say the defensive remit has increasingly moved to supporting homeland security as well as the military in recent years.

A large building is being constructed in one corner of the campus. There have been claims from Russia that it might be some kind of chemical weapons factory.

"That's just nonsense. This is a defensive organisation," Sir David Pepper, the chairman of DSTL, told the BBC, in response to those claims.

Officials at DSTL say the planning application has long been available at the local council, explaining that it going to be a new facility for forensic analysis of explosives.

DSTL has been involved in recent investigations including the attack at the Manchester Arena last year. New money to upgrade facilities was recently announced.

International inspectors from the Organisation for the Prohibition of Chemical Weapons have arrived in the UK. They have been to the location in Salisbury and have also been given permission, following approval by a judge, to take a sample of the Skripals' blood.

They are also present at Porton Down itself. The DSTL is an OPCW certified lab and the inspectors will be carrying out their own work here and at other labs around the world to independently verify the work done by DSTL.

Related Topics

Russian spy poisoning

Military

Read more: http://www.bbc.com/news/uk

http://coehealthandfitnessreport.com/?p=1456

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michaeldcoe · 7 years ago

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Being an agent 'messed up' ex-spy's life

Media playback is unsupported on your device

Media captionSkripal 'regretted being double agent'

Sergei Skripal regretted being "a double agent" because his life had become "all messed up", a friend of the Russian former spy has told the BBC.

Vladimir Timoshkov also said Mr Skripal did not see himself as a "traitor" because the "oath he had sworn was to his socialist Motherland, the Soviet Union, not Russia".

He added the ex-spy had asked Vladimir Putin to be allowed back into Russia.

Mr Skripal and his daughter Yulia remain in a critical condition.

Image copyright EPA/ Yulia Skripal/Facebook Image caption Sergei Skripal, 66, and his daughter Yulia, 33 were poisoned by a nerve agent called Novichok

Mr Skripal was "shunned" after being convicted of treason and his old classmates felt he had betrayed his country, said Mr Timoshkov - a school friend of Mr Skripal's.

He told the BBC he had reconnected with Mr Skripal through his daughter Yulia after the conviction and in 2012 spoke to his old friend on the telephone for half an hour.

According to Mr Timoshkov, Mr Skripal denied he was "a traitor" and had written to Russian President Vladimir Putin to ask for "complete forgiveness".

He also asked to be allowed to return to Russia because he wanted to see his mother, brother and other relatives.

The Kremlin denies receiving a letter from Mr Skripal.

Image copyright Getty Images

The UK's military research base, Proton Down, said a group of nerve agents known as Novichok were used in the poisoning of Mr Skripal and his daughter.

The site's chief executive told the BBC there is "no way" any nerve agent held at Porton Down could be linked to the poisoning of a Russian ex-spy and his daughter.

Gary Aitkenhead said suggestions by Russia that the proximity of the labs to the incident in Salisbury might be somehow suspicious were "frustrating".

He said the laboratory had the "highest levels" of controls and security.

Inside Porton Down

Russian spy: What we know so far

EU recalls Russia ambassador in spy row

Who controls the world's most toxic chemicals?

In updated advice, Public Health England (PHE) said people who had been in the Mill pub and Zizzi restaurant in Salisbury visited by the Skripals wearing clothing that can only be dry cleaned should arrange to have their items collected by the council.

It said anyone in either venue between 13:30 GMT on Sunday 4 March and closure on Monday should arrange to have their clothes collected and they will be compensated.

PHE's earlier advice had been to wash possessions as a precaution and double bag in plastic clothes that needed dry cleaning until further notice.

EU coordinated action

Meanwhile, the 23 British diplomats ordered out of Russia in a tit-for-tat response to the UK's expulsion of 23 of its diplomats have arrived at RAF Brize Norton, the Foreign Office said.

It comes as EU leaders promised further, coordinated action against Russia in response to the attack, endorsing a warning from Prime Minister Theresa May that the poisoning represented a challenge to shared European values.

Image copyright PA Image caption A charter flight from Moscow lands at RAF Brize Norton carrying the British diplomats and their families expelled from Moscow over the Salisbury nerve agent attack.

The EU has recalled its ambassador to Russia, German Markus Ederer, "for consultations" after saying on Thursday it was "highly likely" Russia was behind the attack.

Has the Russian row given UK diplomacy new focus?

Moscow, which denies responsibility for the attack, has accused the European Union of following an "anti-Russian campaign launched by London".

Media playback is unsupported on your device

Media captionThe war of words between the UK and Russia

President Putin has called for the Russian people to unite behind him during what he called a "challenging time".

The bench the Skripals were sitting on when they were found unconscious on in Salisbury on 4 March has been removed by a team in protective suits, as the investigation continues.

A policeman left critically ill after responding to the incident was discharged from hospital on Thursday.

The Russian embassy in London wrote a public letter to Det Sgt Nick Bailey, saying it was "relieved" at his recovery and hoped the Skripals would "get well soon too".

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— Russian Embassy, UK (@RussianEmbassy) March 23, 2018

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Related Topics

UK-Russia relations

Russian spy poisoning

Salisbury

Read more: http://www.bbc.com/news/uk

http://coehealthandfitnessreport.com/?p=1451

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michaeldcoe · 7 years ago

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The mother whose morning sickness has never gone away

Image copyright Caitlin Dean Image caption Caitlin Dean with daughter Orla: "Even though my second pregnancy was my worst, I knew I wanted three kids"

Extreme morning sickness has been given a higher profile in recent years because of the trials of the Duchess of Cambridge, who is pregnant with her third child. But few people know hyperemesis gravidarum (HG) can continue to affect women years after a baby is born.

Caitlin Dean, who has three children aged nine, seven and five, had extreme symptoms during all of her pregnancies.

"It literally felt like my whole body was being poisoned," said the 37-year-old.

"I was being sick 20 to 30 times a day and I got rapidly dehydrated.

"I was vomiting so violently I tore a stomach muscle, which has given me long-term back pain - and I consider I got off lightly."

Image copyright Caitlin Dean Image caption Mrs Dean with Alfie, Patrick and Orla: "HG has made me stronger and more resilient"

HG, which is thought to affect one in every 100 pregnant women, can cause sufferers to lose more than 5% of their normal body weight because they are unable to keep food and liquids down.

Vitamin deficiencies, and other issues associated with malnutrition, can lead to long-lasting symptoms.

Some women suffer so badly they are prepared to terminate the pregnancy, or even consider taking their own lives.

Related Topics

Babies & toddlers

Plymouth

Liskeard

Pregnancy

Read more: http://www.bbc.com/news/uk

http://coehealthandfitnessreport.com/?p=1438

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michaeldcoe · 7 years ago

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Parsons Green Tube bomber jailed for life

Image copyright Met Police

A teenager has been described as "dangerous and devious" by a judge as he was jailed for life for planting a bomb on a Tube train at Parsons Green.

Ahmed Hassan's device partially exploded in September, injuring 51.

The 18-year-old, found guilty of attempted murder, was ordered to serve a minimum of 34 years.

Police said Hassan, from Surrey, appeared to be co-operating with government deradicalisation programme Prevent at the time of the attack.

But the BBC has been told the Iraqi asylum seeker had not agreed to take part in the Prevent scheme, which operates on the basis that people regarded "at risk" give their consent.

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In victim impact statements read out in court, commuters said they believed they were going to die and described how they had been troubled by disturbing recollections and fears.

Passing sentence, the judge, Mr Justice Haddon-Cave, said he would be treating the incident as a terrorist offence.

In a January 2016 immigration interview, Hassan told officials he had been in contact with the Islamic State group and had been "trained to kill". The trial also heard he blamed the UK for the death of his father in Iraq.

The judge told Hassan: "There is no doubt that you are a very dangerous and devious individual.

"You quietly went about planning and executing this terrorist bomb attack with ruthless determination and almost military efficiency, whilst pretending to be a model asylum-seeker."

He added: "I am satisfied you were determined to create as much death and carnage that day as possible."

Media playback is unsupported on your device

Media captionCCTV of Parson's Green Tube bomb fireball

Police have said Hassan appeared to be co-operating with its Channel programme, part of the Prevent deradicalisation scheme, at the time of the attack.

But the BBC understands Hassan had not agreed to take part - despite consent being a fundamental principle of the programme.

In a statement, Surrey County Council said that staff from the local Channel panel met Hassan on many occasions between February 2016 and September 2017.

The council said Hassan had received "extensive support" including from mental health and educational experts, which the Channel panel monitored and reviewed.

Surrey acknowledged Hassan did not have a specialist mentor from the programme working with him.

It refused to respond when asked if Hassan had consented to be on the Channel programme.

'Shaking and anxious'

Hassan's bomb partially exploded at 08:20 GMT after the train arrived at Parsons Green station, leaving 23 people with burn injuries and 28 suffering crush injuries as they fled from the train and station.

Prosecutors at the sentencing hearing said there would have been "serious harm, if not fatality" if the bomb - packed with 2kg of screwdrivers, knives, nuts and bolts - had fully detonated.

Image copyright Met Police Image caption Hassan left his bomb in the carriage and left the train

Hassan had built the bomb in the home of his foster parents in Sunbury-on-Thames while they were away.

On the morning of 15 September, he took a westbound District Line train from Wimbledon, getting off one stop before Parsons Green. His device, which had a timer and was placed in a supermarket plastic bag, was left on the floor of the carriage.

He was arrested the following morning at Dover.

Hassan arrived in the UK in a lorry after having spent time in the migrant camp in Calais known as the Jungle and he was referred to Surrey County Council's social services - a standard procedure for unaccompanied child asylum seekers.

Hassan's foster parents were not aware of the concerns that he harboured extremist views.

Following the verdict, Surrey County Council apologised, saying its work "wasn't as good as it should have been" in helping to stop individuals from being drawn to terrorism.

In a victim impact statement read by prosecutor Alison Morgan, Stephen Nash said he had to give up his job as a social worker because he feared getting on the Tube since the incident and does not like being amongst crowds.

Ann Stuart said she became "tearful for no discernible reason" and had frightening dreams, adding: "Since this happened I wake most mornings shaking and anxious".

Another victim, identified only as Miss S who suffering 16% burns to her body after the fire from the device melted her tights, had to see a psychologist.

Related Topics

Sunbury-on-Thames

Parsons Green bombing

Parsons Green bomb trial

Read more: http://www.bbc.com/news/uk

http://coehealthandfitnessreport.com/?p=1425

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michaeldcoe · 7 years ago

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England TB rates fall by third since 2012

Image copyright Science Photo Library

New figures show rates of tuberculosis (TB) in England have declined by a third in six years, and are currently at their lowest level in 35 years.

The data from Public Health England shows a 38% fall since 2012, with a 9.3% decline in cases in 2017 alone.

Improved diagnosis, treatment and awareness are being credited for the fall.

But England still has one of the highest rates of TB in Western Europe with just under 5,200 affected in 2017.

And TB is still one of the leading causes of death worldwide.

The data has been released to coincide with World TB Day on 24 March.

The World Health Organization's campaign Light up the World for TB will see buildings and landmarks across the world lit up in red across the weekend 23-25 March.

It's hoped it will highlight the continued focus that is required to meet the ultimate ambition of making England TB-free.

Image copyright Science Photo Library Image caption The BCG vaccine offers protection against TB

Dr Sarah Anderson, head of the National TB Office at Public Health England, said: "People often think that TB is a Victorian disease that is no longer a problem in England, but in fact it still affects over 5,000 people a year and there is still a lot to do until the target to eliminate TB is met.

"We urge everyone to join the fight to confine TB to history. World TB Day is an opportunity for people everywhere to be informed about TB, educate others and urge governments to take action. This global movement will make a powerful statement and show solidarity for people who have been affected by TB."

Tuberculosis facts

TB is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person

It mainly affects the lungs, but it can affect any part of the body, including the tummy (abdomen) glands, bones and nervous system

The most common symptoms of TB are a persistent cough for more than three weeks, unexplained weight loss, fever and night sweats.

TB is difficult to catch and you need to spend many hours in close contact with a person with infectious TB to be at risk of infection

TB can be fatal if left untreated - but can be cured if it's treated with the right antibiotics over a course of six months

The BCG vaccine offers protection against TB, and is recommended for babies, children and adults under the age of 35 who are at risk of catching TB

At-risk groups include: children living in areas with high rates of TB and people with close family members from countries with high TB rates

The most recent data on infection rates show parts of London still have higher rates of TB than some developing countries, such as Iraq, Libya and even Yemen.

London is known as the TB capital of Western Europe and has seen initiatives such as a mobile clinic taking to the capital's streets to test vulnerable people, such as the homeless.

Free testing and treatment of latent TB is available in England for people from areas where TB is common.

TB breakthrough

Last year researchers in Oxford and Birmingham reported they had made a world-first breakthrough in the diagnosis of tuberculosis.

They managed to isolate different strains of the disease using a process called genome sequencing.

It means patients who may have waited months to get the right drugs can now be diagnosed in only a few days - so they have a greater chance of recovery.

While figures have gone down over the last six years in England, another issue in the battle to eradicate TB is drug resistance.

A recent study found one in five global cases of the disease is now resistant to at least one major treatment drug.

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michaeldcoe · 7 years ago

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Lone parents: 30,000 families made homeless

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Media caption Ed Thomas met parents in Oldham who struggle to buy food and basic necessities for their children

Almost 30,000 single parent families were made homeless last year, up 8% on five years ago, according to new official figures.

Housing charity Shelter said government figures also reveal that nearly three-quarters of homeless households in England are lone parent families.

Shelter said lone parents were bearing the brunt of the housing crisis, by juggling part-time work and childcare.

The government said it was investing £1.2bn in tackling homelessness.

Polly Neate, chief executive of Shelter, said: "Of the thousands of families battling with the grim reality of homelessness, the vast majority are single parents."

Their limited incomes make it hard for them to contend with high private rents and welfare cuts, she added.

'Safety net?'

Dalia Ben-Galim, policy director at charity Gingerbread, said more and more single parents were reaching out to the charity for advice and support when facing eviction and homelessness.

"The vast majority of single parents are working.

"But with a perfect storm of rising living costs, stagnating wages and changes to the benefit system eroding an essential safety net for families, single parents are hard hit and struggling to keep a roof above their children's heads."

She added that Universal Credit and the benefit cap must be reformed to reduce the disproportionate negative impact changes are having on single parents.

The vast majority of families with children will be housed in temporary accommodation rather than being left to sleep rough.

The statistics, published on Thursday, also show the number of households in temporary accommodation has risen by nearly two-thirds since 2010.

'Dangerous'

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On 31 December last year, 78,930 households were in temporary accommodation, up 64% since the start of the decade.

The figure was also 4% higher than last year, when there were 75,740.

Jon Sparkes, chief executive of homeless charity Crisis, said: "Temporary accommodation is often cramped, unsuitable and sometimes even dangerous.

"It can have a devastating impact on people's lives and mental health, and it's no place for anyone to call home."

Homelessness minister Heather Wheeler said: "Government is serious about reducing homelessness and rough sleeping - we're investing £1.2bn to 2020 to address the issue and next month sees the most ambitious legislation in decades to prevent homelessness come into force.

"These latest statistics show encouraging signs that our investment and targeted support for local authorities is having a positive impact."

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Sport Relief rethinks star appeal films

Image copyright Comic Relief Image caption Ed Sheeran made a Comic Relief film in Liberia last year

Sport Relief isn't using appeal films showing stars visiting developing countries after complaints that they were akin to "poverty tourism".

Sport Relief, which is on TV on the BBC on Friday, takes place every other year, alternating with Red Nose Day.

The Comic Relief charity runs both events and said future films would just feature people who live in those countries speaking for themselves.

MP David Lammy had said they portrayed Africans as "victims to be pitied".

The Sport Relief and Red Nose Day telethons usually feature clips of well-known personalities meeting people in Africa and other countries where the charity works.

'Local heroes'

But Comic Relief chief executive Liz Warner said: "This year, we are putting people at the heart of the films.

"We haven't sent celebrities, for the night of TV, to Africa. People are telling their stories in their own voices, and we are using local heroes."

A 2017 Red Nose Day film fronted by Ed Sheeran, about street children in Liberia, was named the "most offensive" campaign last year by a fundraising pressure group.

In it, the singer was seen meeting a young boy before offering to pay for a hotel for him and his friends. The Radi-Aid awards said it was almost "poverty tourism".

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Warner told Radio 4's World at One they were continuing to work with celebrities - just in a different way.

"It's in our DNA," she said of having stars at the centre of their campaigns. "But we're continuing to evolve how we make our films."

Asked about the Sheeran film, she added: "We're very proud of what Ed did. The celebrities give of their time and they do amazing things for us. We're just trying to work out how we work with them."

Image copyright PA Image caption Ball cycled more than 350 miles from her home town to where she lives now

The charity plans to enlist more celebrities to speak about issues that are close to their hearts - such as with Zoe Ball's cycling challenge to raise awareness of male mental health.

Friday's Sport Relief will include a film about street children in Uganda. It will be introduced by Rio Ferdinand, but he will not appear in the clip himself. Instead, it will feature the children and a charity worker.

Stars will appear in films about the UK, though, with John Bishop fronting a clip about a project near his home in the north-west of England.

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Media captionDavid Lammy says African people are "equals to be respected, not as victims to be pitied".

Sport Relief, which aims to raise millions for disadvantaged people in the UK and around the world, is a week-long event this year, culminating in the live broadcast on Friday night.

The move comes after David Lammy made a film for BBC Two's Daily Politics, saying Comic Relief had "tattooed images of poverty in Africa to our national psyche" - and was not showing the full reality of life on the continent.

"Sports Relief should be helping to establish the people of Africa as equals to be respected, not as victims to be pitied," he said.

"So, rather than getting celebrities to act as tour guides, why not get Africans to talk for themselves about the continent and the problems that they know?"

'Step in the right direction'

Lammy has agreed to talk to Comic Relief - and has been invited to make a film for them himself.

He said on Friday: "I am pleased that Comic Relief has listened to concerns that I have raised and will be making changes to their output.

"I hope that the films they make will respect and empower African people and amplify their voices instead of patronising them. This represents a step in the right direction and some progress."

Sport Relief is on BBC One from 19:00 on Friday.

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'No way' spy nerve agent came from UK lab

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There is "no way" any nerve agent held at the UK's Porton Down lab could be linked to the poisoning of a Russian ex-spy and his daughter, the site's chief executive has told the BBC.

Gary Aitkenhead said suggestions by Russia that the proximity of the labs to the incident Salisbury might be somehow suspicious were "frustrating" .

He said the laboratory had the "highest levels" of controls and security.

Sergei Skripal and his daughter Yulia remain in a critical condition.

Inside Porton Down

Russian spy: What we know so far

EU recalls Russia ambassador in spy row

Who controls the world's most toxic chemicals?

In updated advice, Public Health England says people who had been in the Mill pub and Zizzi restaurant in Salisbury visited by the Skripals wearing clothing that can only be dry cleaned should arrange to have their items collected by the council.

It says anyone in either venue between 13:30 GMT on Sunday 4 March and closure on Monday should arrange to have their clothes collected by the council and they will be compensated.

PHE's earlier advice had been to wash possessions as a precaution and double bag in plastic clothes that needed dry cleaning until further notice.

EU coordinated action

Meanwhile, the 23 British diplomats ordered out of Russia in a tit-for-tat response to the UK's expulsion of 23 of its diplomats have now arrived at RAF Brize Norton, the Foreign Office said.

It come as EU leaders have promised further, coordinated action against Russia in response to the attack, endorsing a warning from Prime Minister Theresa May that the poisoning represented a challenge to shared European values.

Has the Russian row given UK diplomacy new focus?

The EU has recalled its ambassador to Russia, German Markus Ederer, "for consultations" after saying on Thursday it was "highly likely" Russia was behind the attack.

Image copyright EPA/ Yulia Skripal/Facebook Image caption Sergei Skripal, 66, and his daughter Yulia, 33, are in a critical condition in hospital

Mrs May had told MPs that scientists at Porton Down had identified the substance used in the attack as belonging to a group of military-grade nerve agents known as Novichok, developed by Russia.

Moscow, which denies responsibility for the attack, has accused the European Union of following an "anti-Russian campaign launched by London".

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Media captionThe war of words between the UK and Russia

President Putin has called for the Russian people to unite behind him during what he called a "challenging time".

The bench the Skripals were sitting on when they were found unconscious on in Salisbury on 4 March has been removed by a team in protective suits, as the investigation continues.

A policeman left critically ill after responding to the incident was discharged from hospital on Thursday.

The Russian embassy in London wrote a public letter to Det Sgt Nick Bailey, saying it was "relieved" at his recovery and hoped the Skripals would "get well soon too".

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Image copyright Getty Images Image caption Porton Down is located about eight miles from Salisbury

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